Forms


Below is a list of AGED’s most common trust forms. While we prefer that you come in the office to discuss your trust needs, some people like to prepare their own documents, or fully review the forms before their meeting.

Click the link to below to jump to the particular forms you are interested in.

These documents are available in PDF format, making it easy to download and print. If you do not have a PDF reader on your computer, you may download one here: Free Adobe Reader.

Instructions

Documentation Needed to Establish a Trust with AGED

Documents Needed for Medicaid Applications

How to Read Your Trust Statement guide

Making Deposits Into a Client’s Special Needs Trust Account *Please call AGED at (407) 682-4111 to obtain deposit instructions*

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The Florida Public Guardianship Pooled Special Needs Trust

AGED has been named the Administrative Trustee for the Florida Public Guardianship Pooled Special Needs Trust. Click here to access the documents for this trust.

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AGED d(4)(C) Pooled Trust Documents

Documentation Needed to Establish a Trust with AGED

AGED Welcome Letter

AGED d(4)(C) Pooled Master Trust Agreement

AGED d(4)(C) Pooled Fee Agreement (Fillable)

AGED d(4)(C) Joinder Agreement (Fillable)

Instructions for Completing Pooled SNT Joinder Agreement

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Sample Petition and Order Authorizing Guardians to Establish a Pooled Trust

Authorization for Direct Transfer VIA ACH

Online Access Form

Disclaimer Regarding Transfers to Pooled Trust for SSI Recipient Age 65 or Older

Disclaimer Regarding Legal Advice

DCF Community Partner Release

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AGED Third Party Trust Documents

Documentation Needed to Establish a Trust with AGED

AGED Welcome Letter

AGED Signed Third Party Master Trust Agreement

AGED Third Party Fee Agreement (Fillable)

AGED Third Party Joinder Agreement (Fillable)

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Authorization for Direct Transfer VIA ACH

Online Access Form

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AGED Group Home and Discounted Nursing Home Medicaid Account Documents

Important Note: AGED’s Discounted Fee Agreement for Nursing Home Medicaid is for individuals in a Nursing Home placing income only and/or less than $5,000 in assets into the trust. If assets are above $5,000 please use AGED’s d(4)(C) Pooled Trust Documents.

Documentation Needed to Establish a Trust with AGED

AGED Welcome Letter

AGED Master Trust

AGED Group Home Fee Agreement (Fillable)

AGED Discounted Fee Agreement for Nursing Home Medicaid (Fillable)

AGED Discounted Nursing Home Medicaid / Group Home Joinder Agreement (Fillable)

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Authorization for Direct Transfer VIA ACH

Online Access Form

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AGED Guardianship Benevolent Fund Documents

Guardianship Benevolent Fund Application (Fillable)

Guardianship Benevolent Fund Instructions

Guardianship Benevolent Fund Disbursement Request Form (Fillable)

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Do you need additional information not located on this page? Feel free to contact us anytime with any questions you may have.

Contact AGED

Phone: (407) 682-4111

Fax: (407) 682-5511

Access Your Account

CHG Program

AGED's Community & Hospital Guardianship (CHG) program gets patients "unstuck" from a hospital or facility.

Learn more about CHG by visiting www.CHGProgram.org.

Community & Hospital Guardianship Program

Florida Adaptive Sports

A program of AGED, Florida Adaptive Sports is a social sports club that helps keep disabled Floridians of all ages healthy for life by providing an outlet for friendship and activity.

Learn more about Florida Adaptive Sports by visiting www.FLAdaptiveSports.org.